Provider Demographics
NPI:1114252111
Name:KAISER FOUNDATION HOSPITAL
Entity Type:Organization
Organization Name:KAISER FOUNDATION HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:PILKINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:209-735-5620
Mailing Address - Street 1:4601 DALE RD
Mailing Address - Street 2:ICU H2312
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9718
Mailing Address - Country:US
Mailing Address - Phone:209-735-7615
Mailing Address - Fax:209-735-7603
Practice Address - Street 1:4601 DALE RD
Practice Address - Street 2:ICU H2312
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9718
Practice Address - Country:US
Practice Address - Phone:209-735-7615
Practice Address - Fax:209-735-7603
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAISER PERMANENTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-08
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA163WC0200X282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital